Trauma Center of Utah, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

TRAUMA CENTER OF UTAH, LLC

Practice address

4980 N University Ave Apt 12
Provo, UT 84604-6444

Phone

(801) 644-4014

NPI assigned

Dec 31, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tonya Porter, LMHC

Title

Clinical Director

Phone

(801) 851-5504

Specialties & licenses 8

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546214400000",
    "number": "1295207231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4980 N UNIVERSITY AVE APT 12",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046444",
            "telephone_number": "801-644-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 N UNIVERSITY AVE APT 12",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046444",
            "telephone_number": "801-644-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA CENTER OF UTAH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-31",
        "last_updated": "2018-12-31",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "801-851-5504",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Townsend, LMFT
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• Vincent Tran
• Jeffrey L Trapnell, D.D.S.
• Traveling Sisters Home Health & Medical LLC
• Nicole Trayner
• Madeline Tree
• Tri Connections, Inc.
• Celia Trifilio, PHYSICIAN ASSISTANT

• Adolescent and Children Mental Health Clinic/Center in Provo, UT
• Providers in Provo, UT by specialty
• Adolescent and Children Mental Health Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.